Authors
Suresh Chandran C J, MD (AIIMS), DM(Neuro), DNB(Neuro), PGCC, MNAMS, FIPM, Diplomate European Board of Neurology1
1Department of Neurology, Kerala Institute of Medical Sciences, Thiruvananthapuram.
Abstract
A 20-year old gentleman presented with one- week history of headache and progressive left hemiparesis. There was asymmetric hyperreflexia in all four limbs (left>right), left hemianesthesia and left plantar was extensor. MRI brain showed multiple lesions in bilateral centrum semiovale, bilateral parietal and right paraventricular regions. The open-ring sign is often present in large, contrast-enhancing demyelinating lesions and helps to differentiate them from neoplasms and infections that usually show complete ring enhancement. Keywords: Hemiparesis, Hyperreflexia, Hemianaesthesia, Open ring sign